Tag Archives: Dentists

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Dental students in Costa Rica design metal saliva ejector to reduce waste

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I feel the urge to use the phrase “going green” to describe what a few dental students have accomplished, but since we’re talking about teeth and oral hygiene, I’ll resist the urge.

Let’s just say this group of dental students has engineered a solution to the wastefulness of one-time use plastic saliva ejectors that most U.S. dentists use daily. Dentists must dispose of plastic saliva ejectors after each patient in accordance with infection control protocols.

But thanks to the ingenuity of these conservation-minded dental students, this could become a thing of the past.

The four students at the University of Costa Rica (UCR) have developed a metallic saliva ejector that can be cleaned in the autoclave and reused again and again.

For example, the team estimated that the UCR Faculty of Dentistry throws away 166 ejectors each day, 3,317 each week, and almost 4,000 each year.

The students also note that if the average dental office sees 12 patients a day, they will throw away a little more than 3,000 ejectors every year. Metal ejectors would eliminate this waste. Not to mention the cost savings!

“Plastic saliva ejectors are one of the instruments used by dentists that generate a big impact at the environmental level,” said Yulieth Segura Castillo, one of the students. “So we proposed a stainless steel, autoclavable, surgical-grade ejector to reduce this impact through a design that meets all of the conditions for professionals who decide to change from the usual plastic ejector.”

The dental students began their research and development process with several prototypes made out of various metals.

During the testing phase, some could not stand the heat, were deformed or failed during use. Next, they worked with a metallurgist to develop a final prototype that successfully passed all sterilization and functionality tests.

Although a metal saliva ejector will cost more than a plastic one, the students call the metal ejector a long-term investment. It will save dentists both the costs of buying thousands of plastic ejectors as well as the costs of disposing of them, since many waste companies that collect biological waste charge by weight.

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Kissing can ward off tooth decay

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Pucker up! It turns out kissing is good for you in more ways than you might think.

Most people know that kissing comes with loads of mental and physical benefits that make getting your smooch on totally worth it. From inducing an increase in happy hormones, including oxytocin, dopamine, serotonin, and a reduction in stress-causing cortisol, kissing is a great way to feel better — mentally, emotionally and even physically!

But science has even more to say about the benefits of a kiss. It turns out kissing can also help prevent cavities. No, really. It’s true.

It may not be as effective as flossing and brushing on a regular basis, but kissing increases the flow of saliva, which then helps prevent tooth decay.

Kissing is nature’s natural cleansing process. According to a study published by the Academy of General Dentistry, kissing stimulates saliva, which washes out the mouth and helps remove the cavity-causing food particles that accumulate after eating. Saliva’s mineral ions have been shown to even promote repair of small imperfections in tooth enamel.

Of course, more than a good-night kiss is needed to fully protect teeth. Besides, slacking on good oral hygiene would probably lead to fewer kisses anyway. So, keep up the daily dental hygiene regimen. And always brush and floss before going to bed, since sleep slows the production of saliva.

No one to kiss? We don’t recommend grabbing a stranger and laying one on. You can get saliva flowing in other ways like chewing gum, too (sugarless, of course).

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Dental professionals support raising legal age for purchasing tobacco to 21

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The American Dental Association (ADA) recently announced its support for a new bill that would raise the legal age to purchase tobacco products from 18 to 21.

The ADA praised lawmakers for introducing Senate Bill 1541, the Tobacco-Free Youth Act. “Preventing oral cancer and other tobacco-related diseases has been a longstanding priority for the ADA,” said ADA President Jeffrey M. Cole and Executive Director Kathleen T. O’Loughlin.

Did You Know?

Nearly 9 out of 10 people who die from oral and pharyngeal cancers use tobacco and the risk of developing these cancers is related to how much (and how often) they use. On average, 40% of those with the disease will not survive more than five years.

Tobacco products are also linked with higher rates of gum disease, periodontal disease, mucosal lesions, bone damage, tooth loss, jaw bone loss and more.

In a letter to lawmakers, the ADA noted the legislation would help prevent tobacco use among our youth by raising the national age to legally purchase tobacco products from 18 to 21 as well as help reduce the number of young people who begin smoking before age 21, which represents 95% of current adult smokers, according to the 2014 National Survey on Drug Use and Health.

E-Cigarettes Under Scrutiny

The bill would also apply to all the young e-cigarette users.

Research shows that young people who use e-cigarettes are much more likely to transition to smoking cigarettes. For that reason, the letter stated that the ADA does not consider these nontraditional tobacco products to be safer (or less harmful) alternatives to smoking.

The ADA has also joined a coalition led by the Campaign for Tobacco-Free Kids supporting the Reversing the Youth Tobacco Epidemic Act of 2019. That legislation addresses the e-cigarette epidemic and calls for the Food and Drug Administration (FDA) to implement health warnings for cigarette packages (including an oral cancer image) within 12 months.

If passed, the act also would raise the minimum age for purchasing non-traditional tobacco products such as e-cigarettes to 21 and prohibit non-face-to-face sales of all tobacco products, including e-cigarettes and e-cigarette accessories.

You can follow all of the ADA’s advocacy efforts on this issue at ADA.org/tobacco.

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Dentists invited to donate services to veterans

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There is more than one way to serve your country. If you’re a dental professional, you have the opportunity to use your unique skills and training to serve those who served our country.

In honor of the Memorial Day holiday, an organization called Dental Lifeline Network announced on May 14 that it is launching a volunteer recruitment campaign encouraging dentists to provide dental care to veterans, specifically those with special needs. Dental Lifeline Network is a nonprofit, humanitarian organization that provides access to comprehensive dental care for vulnerable people with special needs, the elderly, and those who are medically compromised.

The program is called “Will You See One Vet” and the campaign asks general dentists and specialists to volunteer and donate their services to help veterans through Dental Lifeline Network. From clearing up painful dental infections to being able to eat again — providing comprehensive dental care can make a life-changing difference for veterans.

Sadly, many veterans do not qualify for dental benefits. According to the U.S. Department of Veterans Affairs, veterans must meet certain eligibility factors in order to receive even routine dental care, such as a service-related dental disability or condition, or be a former prisoner of war.

The campaign utilizes imagery of veterans sharing their life-changing stories after receiving comprehensive dental care in targeted outreach, media and advertising. This includes a radio public service announcement that will run nationwide in donated time all month long.

“This awareness campaign showcases the life-changing difference our volunteers have made in the lives of veterans,” said Fred Leviton, CEO of Dental Lifeline Network, in a recent news release. “We hope sharing this message will inspire even more volunteers to participate in our program, allowing DLN to serve a greater number of veterans in our communities.”

Dental Lifeline Network is made up of more than 15,000 volunteer dentists and 3,500 volunteer laboratories.For more information on volunteering, visit WillYouSeeOneVet.org. To donate, visit dentallifeline.org/donate.

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Orofacial pain could become dentistry’s newest specialty

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For starters, let’s define orofacial pain. It will be helpful in understanding how (and whether) it might become dentistry’s newest specialty as recognized by the National Commission for Recognition of Dental Specialties and Certifying Boards’ review committee.

Orofacial pain is a broad term used to describe symptoms of pain and/or dysfunction in the head and neck region. Think headaches, jaw pain and much, much more. According to the American Academy of Orofacial Pain, orofacial pain is evolving and the scope of the field is enlarging.

Currently, orofacial pain encompasses:

  • Temporomandibular joint disorders
  • Masticatory musculoskeletal pain
  • Cervical musculoskeletal pain
  • Neurovascular pain
  • Neuropathic pain
  • Sleep disorders related to orofacial pain
  • Orofacial dystonias
  • Headaches
  • Intraoral, intracranial, extracranial and systemic disorders that cause orofacial pain

In early May, the American Academy of Orofacial Pain submitted an application and request to recognize Orofacial Pain as a dental specialty, which is now under review by the National Commission for Recognition of Dental Specialties and Certifying Boards’ review committee.

According to the National Commission, all documentation in the application is confidential until the review committee has determined that the application is complete. If the application is complete, the National Commission will invite public comment on the applicant’s compliance with the requirements for recognition for a 60-day period.

Specialties currently recognized by the National Commission include Dental Anesthesiology; Dental Public Health; Endodontics; Oral and Maxillofacial Pathology; Oral and Maxillofacial Radiology; and Oral and Maxillofacial Surgery.

The field of orofacial pain is concerned with the prevention, evaluation, diagnosis, treatment and rehabilitation of orofacial pain disorders, according to the AAOP website. Such disorders may have pain and associated symptoms arising from a discrete cause, such as postoperative pain or pain associated with a malignancy, or may be syndromes in which pain constitutes the primary problem.

The National Commission, at its March 11 meeting, revised its policies related to the application process requiring it to publish a notification to its communities of interest when an application has been received.

For more information on the National Commission on Recognition of Dental Specialties and Certifying Boards, visit ADA.org/en/ncrdscb or by calling 1-312-440-2697.

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The mechanism of caries and the anti-caries action of fluoride

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At present, around two-thirds of U.S. households have fluoridated water in their houses. The CDC has made nationwide fluoridation of drinking water a top priority for the prevention of cavities.

In 1945, Grand Rapids, Michigan, became the first U.S. city to implement community fluoridation of the water supply. Fluoride isn’t just found in tap water, of course. It’s also found naturally and fortified in certain foods.

Additionally, fluoride is a common ingredient in tooth varnish or gels, mouthwashes, prophy paste, and toothpaste, with an aim to reverse tooth decay.

How fluoride prevents cavities

We know our mouths house trillions of bacteria, which can form microcolonies on our teeth. When these microcolonies coalesce, it makes a layer of dental plaque.

However, bacteria have a hard time getting into the tooth because of the outer layer of the tooth, called enamel, which is made of a hard substance called hydroxyapatite. Hydroxyapatite is a type of calcium phosphate crystal with the chemical formula Ca10(PO4)6(OH)2.

When bacteria on the tooth surface start to grow, they break down sugar in foods and drinks and release acid as a waste product, which can cause the enamel to break down. Without hydroxyapatite, the tooth enamel can become weak and allow bacteria to enter, causing permanent damage — this is called a cavity.

If left untreated, the bacteria can infect the root of the tooth resulting in pain. This is where fluoride comes in.

Fluoride can replace the OH group in hydroxyapatite to create fluorapatite with the chemical formula Ca10(PO4)6(F)2. In general, fluorapatite is denser and less soluble than hydroxyapatite, so it’s less likely to demineralize. Fluorapatite is found in the strongest animals’ teeth.

Fluoride also accumulates in your teeth over time. So, while fluoride treatments are useful throughout your life, treatments are generally more important during childhood and adolescence. This is why fluoride varnish and gels for children are becoming more popular in recent days.

How fluoride treatments work

According to a meta-analysis that looked at 20 studies exploring the effects of fluoridation of drinking water on cavities in children, fluoride in the water leads to a 35% reduction of tooth decay in baby teeth and a 26% reduction in tooth decay of permanent teeth.

Another meta-analysis looked at 22 studies exploring the effect of applying a fluoride varnish to children’s teeth every 3 to 6 months at the dentist’s office found a 37% reduction in baby teeth and a 43% reduction in tooth decay in permanent teeth.

A third meta-analysis looked at 25 studies focusing on fluoride gel treatments given at least one time a year at the dentist’s office, generally to children older than 6 years old, which showed a reduction of 28% in tooth decay. A fourth meta-analysis looked at 35 studies that the effect of fluoridated mouth rinses given daily to every other week, and found a 23% reduction in tooth decay.

What the findings mean

If we look at meta-analyses of studies that focus on fluoridated toothpaste, it’s clear that it reduces tooth decay and that the effect is stronger with higher fluoride concentrations in the toothpaste, higher frequency of tooth brushing, and supervised brushing.

This was further supported by another meta-analysis that looked carefully at the amount of fluoride in the toothpaste.

This study showed that brushing with fluoridated toothpaste with a fluoride concentration of at least 0.1% prevents tooth decay in children and adolescents aged 16 years or less. There was a 23% reduction in tooth decay at concentrations of 0.1% to 0.125% fluoride and up to a 33% reduction in concentrations ranging from 0.24% to 0.28% fluoride.

Now, while fluoride can be toxic at doses well above those used for dental hygiene, the main concern with using fluoride has generally been fluorosis. Fluorosis is not a disease, but rather a cosmetic condition caused by overexposure to fluoride. Mild forms of fluorosis are common, with up to 41% of children and adolescents having some form of it.

It usually takes the form of subtle white patches on the teeth that are barely noticeable. In moderate to severe cases, which occur in less than 2-4% of the population, there can be significant mottling of the teeth with brown staining. While fluorosis is not generally a health concern, it can lead to social stigma.

A meta-analysis of 25 studies looked at whether brushing teeth with fluoridated toothpaste is linked to fluorosis and found that brushing the teeth of infants under 1 year old may increase the risk of fluorosis, but that relationship was weak.

There was a stronger relationship for children between the ages of 12 months and 6 years of age. If these children brushed with a toothpaste that was higher than 0.1% fluoride or more, they had a 30% chance of developing mild fluorosis.

This means that the risks of tooth decay, which are decreased over fluoride concentration of 0.1% fluoride or more must be balanced with the risk of fluorosis which increases fluoride concentrations over 0.1% fluoride.

Wrapping up

Tooth decay and dental cavities are leading health concerns around the world. In general, fluoridation of the water supply, and applying fluoride to the teeth via tooth varnishes, gels, mouth rinses, and toothpaste has helped decrease tooth decay.

While fluoride is generally considered safe at the concentrations used in fluoridated products, overexposure can lead to fluorosis. In some cases, risking fluorosis may be preferable to risking tooth decay in children at high-risk for tooth decay. So, it may be beneficial to discuss treatment options with your dentist.

In addition, the American Dental Association recommends preventing overexposure by brushing children’s teeth with only a grain-of-rice-sized smear of fluoridated toothpaste from when the teeth begin to erupt to about 3 years of age, and up to a pea-sized bead of toothpaste for children over 3 years old.

For children that are old enough to brush their own teeth, it’s also a good idea to monitor their brushing to decrease the likelihood that they swallow the toothpaste, which can also lead to overexposure and fluorosis.

The use of fluoride varnish in children could be even better as it may reduce the chance of frequent exposure to fluoride, thus reducing the risk of dental decay more than any other form of treatment.

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AI makes its way to dentistry

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Dentistry is a field that evolves by leaps and bounds, and in other ways, remains fairly unchanged over the course of time. For example, new materials mean fillings last longer, resist decay better and act and feel more like a real tooth. That’s progress.

Some things never change. Like the need for good oral hygiene, for instance. My childhood dentist probably recommended the same hygiene routine — brushing twice a day, flossing daily and two cleanings a year — that is recommended today.

But one advancement is blowing those others out of the water. The field of artificial intelligence (AI) is making its way into the dentistry and may be featured at an office near you in the very near future.

Pearl, a Santa Monica, California-based startup applying AI to dentistry, recently announced that it has raised $11 million in funding, led by Craft Ventures and unnamed strategic dental industry partners.

Pearl’s CEO Ophir Tanz spearheaded the development of AI dental technologies, said the fresh capital will further Pearl’s progress toward creating a holistic oral health platform.

“Pearl will have an immediate positive impact on the dental category,” said Tanz. “It will streamline tedious, repetitive tasks, enhance profitability across dentistry, and, most importantly, it will improve the standard of care by validating diagnoses, removing large elements of uncertainty from the dental equation.”

What’s AI?

Artificial intelligence (AI) makes it possible for machines to learn from experience, adjust to new inputs and perform human-like tasks. Most AI examples that you hear about today — from chess-playing computers to self-driving cars — rely heavily on deep learning and natural language processing.

Using these technologies, computers can be trained to accomplish specific tasks by processing large amounts of data and recognizing patterns in the data.

Cool, right?

How Will AI Help in Dentistry Specifically?

Two ways Tanz predicts AI integration into a dental practice are identifying “dozens” of common pathologies in dental X-rays and creating structured medical records while self-improving from live feedback.

If that goes well, Pearl will incorporate new research to flag early indicators of disease and tie oral health to full-body health (and vice-versa).

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Oral health improving for most Americans, but economic and ethnic disparities still exist

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There’s some good news and some bad news from the Centers for Disease Control regarding the oral health of the nation.

According to a report, there have been significant improvements in oral health for Americans of all ages.

That’s the good news.

More older Americans are keeping their natural teeth. Moderate to severe periodontitis (gum disease) among adults has decreased significantly.

Use of dental sealants in young people ages 6-19 years has increased and tooth decay in school-age children has declined. And children from low-income families appear to be getting more dental treatment.

All great news!

Yet the report, based on data from the CDC’s National Center for Health Statistics (NCHS) — which represents the most comprehensive assessment of oral health data available for the U.S. population to date — reconfirms a hard truth.

Economic and racial/ethnic disparities in oral health persist.

That’s not such good news.

31% of Mexican-American children aged 6-11 years have experienced decay in their permanent teeth compared to 19% of non-Hispanic white children.

12% of children aged 6-11 from families that live below the poverty line had untreated decay, compared to 4% in families with income above the poverty line. The report also records an increase in tooth decay in the primary teeth of children aged 2-5 years, from 24% to 28%.

“This report shows that while we are continuing to make strides in prevention of tooth decay, this disease clearly remains a problem for some racial and ethnic groups, many of whom have more treated and untreated tooth decay compared with other groups,” said Dr. Bruce A. Dye, an NCHS dentist and the report’s lead author.

What can be done?

Beyond education on the importance of oral hygiene and brushing, there are a number of public health steps we can take to address tooth decay in children and adults, too. From addressing dental shortages in underserved communities to advocating for change in public health policies, there are many ways to get involved in making affordable dental care accessible to more Americans.

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Study: Orthodontic treatment doesn’t guarantee future oral health

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Orthodontic treatment can straighten your teeth, but it can’t protect those choppers from developing tooth decay in the future. When polled, many people think that orthodontic treatment will prevent future tooth decay. But new research out of the University of Adelaide in South Australia has found that this is not the case.

Published in the journal Community Dentistry and Oral Epidemiology, the study, conducted by Dr. Esma J. Dogramaci and co-author Professor David Brennan from the University’s Adelaide Dental School, assessed the long-term dental health of 448 people from South Australia.

“The study found that people who had orthodontic treatment did not have better dental health later in life,” says Dr. Dogramaci. “Patients often complain about their crooked teeth and want braces to make their teeth straight so they can avoid problems, like decay, in the future.”

The study, which followed people from the age of 13 until they were 30, recorded patients’ dental health behaviors and the number of decayed, missing or filled teeth over that period of time.

The cost of orthodontic treatment, in which crooked teeth are realigned using braces worn over several years, varies according to the severity of the problem and whether braces are placed on one arch or both and what materials are used.

The average price tag in America for braces? Anywhere from $3,000 to $7,000, according to the American Association of Orthodontics, depending on the factors named above.

Braces have typically been a teenage rite of passage. But they are becoming increasingly popular in the adult population, with one in five patients being adults. The global orthodontics market is predicted to be worth more than $6 billion by 2023.

“Evidence from the research clearly shows that people cannot avoid regularly brushing their teeth, good oral hygiene and regular dental check-ups to prevent decay in later life,” says Dr. Dogramaci. “Having your teeth straightened does not prevent tooth decay in later life.”

The research was carried out by the Adelaide Dental School, and the Australian Research Centre for Population Oral Health (ARCOPH), the University of Adelaide.

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Anesthesiology recognized as 10th dental specialty

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About 175 years ago, a dentist in Hartford, Connecticut, extracted one of his own third molars to test the analgesic properties of nitrous oxide. It was risky. But it paid off.

That’s a commitment to science right there.

It was Dr. Horace Wells’ introduction of nitrous oxide, and the demonstration of anesthetic properties of ether by Dr. William Morton, a student of Dr. Wells, that gave the gift of anesthesia to medicine and dentistry. Thanks, doctors!

And now, in 2019, dental anesthesiology has become the 10th dental specialty as recognized by the National Commission on Recognition of Dental Specialties and Certifying Boards. The recognition is a result of the National Commission adopting a resolution earlier this year based on an application from the American Society of Dentist Anesthesiologists to recognize dental anesthesiology as a dental specialty.

“This historic vote by the National Commission certainly reflects the ADA’s ongoing efforts towards improved patient care and safety in the areas of dental sedation, dental anesthesiology and access for those with special health care needs,” said Dr. James Tom, president of the American Society of Dentist Anesthesiologists.

Dental anesthesiology joins the following dental specialties: dental public health; endodontics; oral and maxillofacial pathology; oral and maxillofacial radiology; oral and maxillofacial surgery; orthodontics and dentofacial orthopedics; pediatric dentistry; periodontics; and prosthodontics.

Dental specialties are recognized and selected “to protect the public, nurture the art and science of dentistry and improve the quality of care,” according to the National Commission website.

A sponsoring organization seeking specialty recognition for a discipline of dentistry must document that the discipline satisfies six requirements, as outlined in the “Requirements for Recognition of Dental Specialties.”

Additionally, the sponsoring organization of the proposed specialty must provide documentation to show that it is a distinct and well-defined field that requires unique knowledge and skills beyond those commonly possessed by dental school graduates; that it requires advanced knowledge and skills; and that it scientifically contributes new knowledge, education and research in both the field, and the profession.

Check, check and check. Welcome to the family, dental anesthesiologists.

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